Spontaneous splenic rupture after thrombolysis for ischemic stroke

Sirbou, Rachid; Tissier, Cindy; Béjot, Yannick; Freysz, M.

doi:10.1016/j.ajem.2014.08.057

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…Because splenic infarction is less symptomatic than other infarct types, and thus often found incidentally, the actual incidence is unclear in acute ischemic stroke patients. However, given that there have been several reports of splenic rupture following thrombolysis in stroke patients, 21,22 splenic infarction may lead to subsequent hemorrhagic events.…”

Section: Discussionmentioning

confidence: 99%

Yield of Whole Body Computed Tomography in Hyper-Acute Stroke Patients With Large Vessel Occlusion

Sakuta,

Yaguchi,

Nakada

et al. 2023

Vasc Endovascular Surg

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Purpose In the majority of cases, large vessel occlusion (LVO) in ischemic stroke patients has an embolic origin. Systemic embolism can occur simultaneously with brain thrombosis. This retrospective study evaluated the frequency and locations of systemic embolism in LVO stroke patients receiving revascularization therapy. Materials and Methods In our facility, we use contrast-enhanced computed tomography (CE-CT) to assess suspected stroke patients and routinely perform CE-CT from the chest to the abdomen after brain CT angiography to rule out contraindications like aortic dissection and trauma for thrombolysis. Systemic embolism is also assessed using these images, while myocardial infarction is evaluated based on electrocardiograms and laboratory findings. Other relevant clinical features of each patient are also analyzed. Results In total, 612 consecutively admitted stroke patients and 32 LVO patients who underwent revascularization therapy were included in the present study. Systemic embolism was identified in four patients (13%). The spleen was the most commonly affected organ, followed by the heart, kidneys, limbs, and lungs. All four patients with systemic embolism exhibited LVO resulting from embolism as the underlying mechanism. Conclusion Systemic embolism was observed in 13% of our LVO patients, all of whom had LVO of embolic origin.

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Section: Discussionmentioning

confidence: 99%

Yield of Whole Body Computed Tomography in Hyper-Acute Stroke Patients With Large Vessel Occlusion

Sakuta,

Yaguchi,

Nakada

et al. 2023

Vasc Endovascular Surg

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“…History of trauma or medication must be thoroughly questioned. Lack of history of trauma may be misleading for clinicians and may cause delayed diagnosis and mortality (6,8). Probability of spleenic rupture must be kept in mind in patients with co-existence of anticoagulant use and abdominal pain (2).…”

Section: Discussionmentioning

confidence: 99%

“…Most common causes are hematologic malignancies and infections (1,2). Anticoagulants, granulocyte-colony stimulating factors, thrombolytic agents, tissue plasminogene activator, streptokinase, antifibrinolytic treatment, thrombolytic treatment and dialysis have been known as causing spontaneous spleen rupture (1)(2)(3)(4)(5)(6)(7). Chronic hepatitis, amyloidosis and pancreatitis have also been known as causing spontaneous spleen rupture (8,9).…”

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confidence: 99%

Spleen Rupture Due to Anticoagulant Use: A Case Report

Uluşahin¹,

Tomas²,

Usta³

et al. 2020

J Basic Clin Health Sci

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Spleen rupture caused by anticoagulant drug use is a rare but potentially fatal condition. Co-existence of oral anticoagulant use and complaint of abdominal pain must remind diagnosis of spleen rupture. In this paper, we aimed to present a case of spleen rupture identified in a patient with history of heart valve replacement and concomitant oral anticoagulant use. A 44-year old male patient admitted to emergency service with complaint of abdominal pain sustained for 12 hours. There was no history of trauma. A subcapsular hematoma sized 9x8 cm in spleen and perihepatic fluid were identified in computerized tomography (CT) examination. There was no active bleeding in abdominal CT angiography; however, emergent surgery was planned for patient due to impaired hemodynamic balance and decreasing hemoglobin level. In laparotomy, extensive hemorrhagic fluid in abdomen and active bleeding in spleen were present. Spleenectomy was performed. Patient was discharged at postoperative 5th day without a serious problem during postoperative monitoring. Spleen rupture is a rare condition in patients with anticoagulant use. Lack of trauma history may mislead clinican and may delay diagnosing. Early and accurate diagnosis is critical for patient.

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“…Harries and Gomez reported a case of a patient with acute myocardial infarction, in which spleen rupture occurred as a complication of the thrombolytic therapy with tenecteplase ( 22 ). Spontaneous spleen rupture following alteplase therapy for stroke was reported only once ( 23 ).…”

Section: Review Of Literaturementioning

confidence: 99%

Spontaneous Splenic Rupture Following Intravenous Thrombolysis with Alteplase Applied as Stroke Therapy - Case Report and Review of Literature

Aleksić-Shihabi

Jadrijević

Milekic

et al. 2016

Med Arh

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Introduction:Stroke is a medical emergency in neurology, and is one of the leading causes of death nowadays. At a recent time, a therapeutic method used in adequate conditions is thrombolysis, a treatment of an emerging clot in the brain vascular system by alteplase. The application of alteplase also has a high risk of life threatening conditions.Case report:This is a brief report of a case with thrombolysis complication which manifested as a spleen rupture.

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Spontaneous splenic rupture after thrombolysis for ischemic stroke

Cited by 8 publications

References 11 publications

Yield of Whole Body Computed Tomography in Hyper-Acute Stroke Patients With Large Vessel Occlusion

Yield of Whole Body Computed Tomography in Hyper-Acute Stroke Patients With Large Vessel Occlusion

Spleen Rupture Due to Anticoagulant Use: A Case Report

Spontaneous Splenic Rupture Following Intravenous Thrombolysis with Alteplase Applied as Stroke Therapy - Case Report and Review of Literature

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